Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects

Objective: One of the common problems that leads to poor sleep quality in the elderly is low back pain. This study aims to evaluate the effect of auriculotherapy (ear acupressure) on the sleep quality of elderly people with chronic low back pain. Methods: This single-blind randomized clinical trial was conducted in 2019 on 70 older adults with chronic low back pain in Kashan, Iran, who were selected using a convenience sampling technique. After obtaining a written informed consent, they were assigned into intervention and sham groups using the block randomization method. In the intervention group, the pressure was applied to ShenMen, sympathetic, subcortex and low back points of the ear, while in the sham group, the pressure was applied to the points that were not associated with the low back pain. The Pittsburgh Sleep Quality Index (PSQI) and McGill Pain Questionnaire (MPQ) were completed at the beginning of the study, at the end of intervention, and one month after the end of intervention. Six patients from the Sham group and 2 patients from the intervention group were excluded from the study. The data of 62 elderly (in sham group 29 and in intervention group 33) according to Per-Protocol (PP) and data of all samples as Intention to Treat (ITT) were analyzed using covariance analysis and repeated measures ANOVA. Results: There was a statistically significant difference between the intervention and sham groups in terms of the duration of disease at baseline (P=0.012). The interaction effect of time and group on the sleep quality was significant (P<0.0001). Sleep quality in the intervention group was significantly better than in the sham group at the end of the intervention and also during the one-month follow-up period (P<0.0001). Within-group comparison results reported a significant difference in the sleep quality between three evaluation times in the intervention group (P<0.0001). Conclusion: Auriculotherapy can improve sleep quality in the elderly with chronic low back pain. It is recommended to use auriculotherapy as a complementary therapy for treating these elderly groups.

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Do Patients of Chronic Low Back Pain have Psychological Comorbidities?

Avicenna Journal of Medicine ◽

10.1055/s-0041-1734385 ◽

2021 ◽

Author(s):

Kritika Singhal ◽

Krishna Prasad Muliyala ◽

Abhijit P. Pakhare ◽

Prateek Behera ◽

John Ashutosh Santoshi

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Sleep Quality ◽

Chronic Low Back Pain ◽

Tertiary Care ◽

Hospital Setting ◽

Low Back ◽

Vas Score ◽

Psychological Comorbidities ◽

Anxiety Depression

Abstract Background Individuals with chronic pain have been reported to have an increased incidence of psychological morbidities. We aimed to examine the prevalence of anxiety, depression, disability, alexithymia, insomnia, and sleep quality in patients having chronic low back pain (LBP) and study their association with the severity of pain and any disability arising from it. Methods This descriptive study was conducted in a tertiary care teaching hospital setting. Fifty adults with nonspecific LBP of > 6-week duration were included. Study instruments employed were patient health questionnaire-9 for depression, generalized anxiety disorder-7 for anxiety, visual analogue scale (VAS) score for pain, Oswestry disability index (ODI) to assess disability, Toronto alexithymia scale-20 for alexithymia, and insomnia severity index and Pittsburgh sleep quality index for insomnia. Descriptive results were expressed as numbers, means, and proportions. Association study between variables was performed using Fisher’s exact test. Results Mean ODI score was 31.54% (95% CI, 26.09–36.99); mean VAS score was 6.08 (95% CI, 5.35–6.81). Insomnia of varying severity was found in 29 patients. Sleep quality was reported as good by 23 patients. One patient had alexithymia. There was significant association between the level of disability and depression, anxiety, insomnia, and sleep quality. The severity of pain had significant association with insomnia but the association with anxiety, depression, alexithymia, and sleep quality was not significant. Conclusions Patients with chronic LBP do have associated psychological comorbidities of varying extent. A “patient-centric” approach when treating patients with chronic LBP is necessary, so that appropriate evaluation of psychiatric and psychosocial comorbidities, sleep problems, and quality of life is done as part of their routine management to ensure the desired outcomes.

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Sleep quality in patients with chronic low back pain: A cross-sectional study assesing its relations with pain, functional status and quality of life

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-140537 ◽

2015 ◽

Vol 28 (3) ◽

pp. 433-441 ◽

Cited By ~ 16

Author(s):

Melek Sezgin ◽

Ebru Zeliha Hasanefendioğlu ◽

Mehmet Ali Sungur ◽

Nurgül Arıncı Incel ◽

Özlem Bölgen Çimen ◽

...

Keyword(s):

Quality Of Life ◽

Low Back Pain ◽

Back Pain ◽

Sleep Quality ◽

Chronic Low Back Pain ◽

Cross Sectional Study ◽

Low Back ◽

Sectional Study ◽

Cross Sectional

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Identifying prognostic factors to determine the level of recovery in servicemembers with chronic low back pain: A prospective cohort study

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200123 ◽

2021 ◽

pp. 1-9

Author(s):

B.M.P. Mourits ◽

M.Z. Meulekamp ◽

P. van der Wurff ◽

C. Lucas

Keyword(s):

Low Back Pain ◽

Prognostic Factors ◽

Back Pain ◽

Chronic Low Back Pain ◽

Rehabilitation Program ◽

Service Members ◽

Secondary Outcome ◽

Low Back ◽

Regression Analyses ◽

Related Factors

OBJECTIVE: The main objective of this study was to identify general and military-related factors that are associated with the level of recovery in Dutch service members with chronic low back pain (CLBP) who followed a rehabilitation program. MATERIAL AND METHOD: One hundred five consecutive service members with CLBP were included in this study. The level of disability, was used to distinguish a recovered and non-recovered group. Level of pain and self-perceived recovery were used as secondary outcome measurements. Differences were evaluated within and between the groups using the Student’s t-test Bivariate logistic regression analyses were used for identifying the prognostic factors related to various outcomes of recovery RESULTS: After following the rehabilitation program, 64.8% of the service members recovered from CLBP. The recovered group, demonstrated significant effect sizes in disability and in pain The non-recovered group showed on disability a non-significant effect and in pain a significant effect. The self-perceived recovery in the recovered group was “much improved” and the non-recovered group “slightly improved”. The results of the bivariate regression analyses showed no significant independent prognostic factors related to recovery. CONCLUSIONS: In this study, no significant independent prognostic factors could be identified that were associated to the various outcomes of recovery in service members with CLBP who followed a rehabilitation program.

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Sleep Quality, Quality of Life and Insomnia Among Patients with Chronic Low Back Pain Compared to Normal Individuals

Sleep and Hypnosis - International Journal ◽

10.5350/sleep.hypn.2017.19.0151 ◽

2018 ◽

pp. 184-189 ◽

Cited By ~ 2

Author(s):

Mahnaz Abbasi ◽

Amir Mohammad Kazemifar ◽

Hasti Fatorechi ◽

Zohreh Yazdi

Keyword(s):

Quality Of Life ◽

Low Back Pain ◽

Back Pain ◽

Sleep Quality ◽

Chronic Low Back Pain ◽

Low Back ◽

Normal Individuals

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Combined abnormal muscle activity and pain-related factors affect disability in patients with chronic low back pain: An association rule analysis

PLoS ONE ◽

10.1371/journal.pone.0244111 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244111

Author(s):

Hayato Shigetoh ◽

Yuki Nishi ◽

Michihiro Osumi ◽

Shu Morioka

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Association Rule ◽

Low Back ◽

Related Factors ◽

Activity Distribution ◽

Rule Analysis ◽

Flexion Relaxation

Objectives In patients with chronic low back pain (CLBP), reduced lumbar flexion-relaxation and reduced variability of muscle activity distribution are reported as abnormal muscle activity. It is not known how abnormal muscle activity and pain-related factors are related to CLBP-based disability. Here, we performed an association rule analysis to investigated how CLBP disability, muscle activity, and pain-related factors in CLBP patients are related. Methods Surface electromyographic signals were recorded from over the bilateral lumbar erector spinae muscle with four-channel electrodes from 24 CLBP patients while they performed a trunk flexion re-extension task. We calculated the average value of muscle activities of all channels and then calculated the flexion relaxation ratio (FRR) and the spatial variability of muscle activities. We also assessed the pain-related factors and CLBP disability by a questionnaire method. A clustering association rules analysis was performed to determine the relationships among pain-related factors, the FRR, and the variability of muscle activity distribution. Results The association rules of severe CLBP disability were divisible into five classes, including ‘low FRR-related rules.’ The rules of the mild CLBP disability were divisible into four classes, including ‘high FRR-related rules’ and ‘high muscle variability-related rules.’ When we combined pain-related factors with the FRR and muscle variability, the relationship between abnormal FRR/muscle variability and CLBP disability became stronger. Discussion Our findings thus highlight the importance of focusing on not only the patients’ pain-related factors but also the abnormal motor control associated with CLBP, which causes CLBP disability.

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